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Start of HH_F. Health Insurance (HI)
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HI001_INTRO
Now I would like to know about health insurance or benefits that your household members might have.
NOW I WOULD LIKE TO KNOW ABOUT HEALTH INSURANCE OR BENEFITS THAT YOUR HOUSEHOLD MEMBERS MIGHT HAVE.
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HI002A
Does any member in your household have Central Government Health Scheme (CGHS)?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE CENTRAL GOVERNMENT HEALTH SCHEME (CGHS)?
1 Yes
2 No
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HI002B
Does any member in your household have Employees State Insurance Scheme (ESIS)?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE EMPLOYEES STATE INSURANCE SCHEME (ESIS)?
1 Yes
2 No
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HI002C
Does any member in your household have Rashtriya Swasthya Bima Yojana (RSBY)?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE RASHTRIYA SWASTHYA BIMA YOJANA (RSBY)?
1 Yes
2 No
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HI002D
Does any member in your household have Other Central government health insurance schemes, please specify:______?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE OTHER CENTRAL GOVERNMENT HEALTH INSURANCE SCHEMES, PLEASE SPECIFY:______?
1 Yes
2 No
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HI002E
Does any member in your household have State government health insurance schemes, please specify:____ [Instruction for CAPI: Pre-load customized drop-down list of insurance schemes based on state]?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE STATE GOVERNMENT HEALTH INSURANCE SCHEMES, PLEASE SPECIFY:____ [INSTRUCTION FOR CAPI: PRE-LOAD CUSTOMIZED DROP-DOWN LIST OF INSURANCE SCHEMES BASED ON STATE]?
1 Yes
2 No
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HI002F
Does any member in your household have Community/ cooperative health insurance schemes, please specify:_____?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE COMMUNITY/ COOPERATIVE HEALTH INSURANCE SCHEMES, PLEASE SPECIFY:_____?
1 Yes
2 No
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HI002G
Does any member in your household have Medical reimbursement from an employer?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE MEDICAL REIMBURSEMENT FROM AN EMPLOYER?
1 Yes
2 No
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HI002H
Does any member in your household have Health insurance through an employer , please specify:____?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE HEALTH INSURANCE THROUGH AN EMPLOYER , PLEASE SPECIFY:____?
1 Yes
2 No
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HI002I
Does any member in your household have privately purchased commercial health insurance, please specify:____?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE PRIVATELY PURCHASED COMMERCIAL HEALTH INSURANCE, PLEASE SPECIFY:____?
1 Yes
2 No
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HI002J
Does any member in your household have Others, please specify ____?
DOES ANY MEMBER IN YOUR HOUSEHOLD HAVE OTHERS, PLEASE SPECIFY ____?
1 Yes
2 No
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If Does any member in your household have Central Government Health Scheme (CGHS)? = 1 Yes
2 No
or Does any member in your household have Employees State Insurance Scheme (ESIS)? = 1 Yes
2 No
or Does any member in your household have Rashtriya Swasthya Bima Yojana (RSBY)? = 1 Yes
2 No
or Does any member in your household have Other Central government health insurance schemes, please specify:______? = 1 Yes
2 No
or Does any member in your household have State government health insurance schemes, please specify:____ [Instruction for CAPI: Pre-load customized drop-down list of insurance schemes based on state]? = 1 Yes
2 No
or Does any member in your household have Community/ cooperative health insurance schemes, please specify:_____? = 1 Yes
2 No
or Does any member in your household have Medical reimbursement from an employer? = 1 Yes
2 No
or Does any member in your household have Health insurance through an employer , please specify:____? = 1 Yes
2 No
or Does any member in your household have privately purchased commercial health insurance, please specify:____? = 1 Yes
2 No
or Does any member in your household have Others, please specify ____? = 1 Yes
2 No
»
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HI003
[Ask only if HI002=1] Who is the policy holder? [Pre-load the household roster] Household Person ID: ____ Non-household members (99)
[ASK ONLY IF HI002=1] WHO IS THE POLICY HOLDER? [PRE-LOAD THE HOUSEHOLD ROSTER] HOUSEHOLD PERSON ID: ____ NON-HOUSEHOLD MEMBERS (99)
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HI004
[Ask only if HI002=1] Who else in the household is covered under this policy? [Instruction for CAPI: Pre-load the household roster, other than recorded in HI003] [Interviewer: Record all HH members who are covered} Household Person ID: ____ Non-household members (99) OR None
[ASK ONLY IF HI002=1] WHO ELSE IN THE HOUSEHOLD IS COVERED UNDER THIS POLICY? [INSTRUCTION FOR CAPI: PRE-LOAD THE HOUSEHOLD ROSTER, OTHER THAN RECORDED IN HI003] [INTERVIEWER: RECORD ALL HH MEMBERS WHO ARE COVERED} HOUSEHOLD PERSON ID: ____ NON-HOUSEHOLD MEMBERS (99) OR NONE
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HI005
[Ask only if HI002=1] What does this health insurance cover? [ Multiple answers are allowed] [Instruction to the Interviewer: Record the covered services as per the respondents answer]
[ASK ONLY IF HI002=1] WHAT DOES THIS HEALTH INSURANCE COVER? [ MULTIPLE ANSWERS ARE ALLOWED] [INSTRUCTION TO THE INTERVIEWER: RECORD THE COVERED SERVICES AS PER THE RESPONDENTS ANSWER]
1 Hospitalization charges
2 Surgery
3 Tests (e.g
4 Doctor visits
5 Medicine
6 Dental care
7 Nursing home care
8 In-home care
9 Other, please specify:___
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HI006
[Ask only if HI002=1] In which month and year did he/she first purchase/ enroll in this Health Insurance? ___Year ___Month [Hard check: Month < 1 or >12] [Hard check: > current year]
[ASK ONLY IF HI002=1] IN WHICH MONTH AND YEAR DID HE/SHE FIRST PURCHASE/ ENROLL IN THIS HEALTH INSURANCE? ___YEAR ___MONTH [HARD CHECK: MONTH < 1 OR >12] [HARD CHECK: > CURRENT YEAR]
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HI007
[Ask only If HI002=1] In which month and year the benefit of this health insurance begin? ____Year ____Month [Hard check: Month < 1 or >12]
[ASK ONLY IF HI002=1] IN WHICH MONTH AND YEAR THE BENEFIT OF THIS HEALTH INSURANCE BEGIN? ____YEAR ____MONTH [HARD CHECK: MONTH < 1 OR >12]
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HI008
[Ask only if HI002=1] What was the amount of last premium (per year) paid for this policy? (In rupees)? Soft check: >50,000]
[ASK ONLY IF HI002=1] WHAT WAS THE AMOUNT OF LAST PREMIUM (PER YEAR) PAID FOR THIS POLICY? (IN RUPEES)? SOFT CHECK: >50,000]
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HI009
[Ask only if HI002=1] What is the maximum amount of insurance coverage (in rupees)? Per Person:____ OR Per Family:_____ [Soft check: >500,000]
[ASK ONLY IF HI002=1] WHAT IS THE MAXIMUM AMOUNT OF INSURANCE COVERAGE (IN RUPEES)? PER PERSON:____ OR PER FAMILY:_____ [SOFT CHECK: >500,000]
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If Does any member in your household have Central Government Health Scheme (CGHS)? = 2 or Does any member in your household have Employees State Insurance Scheme (ESIS)? = 2 or Does any member in your household have Rashtriya Swasthya Bima Yojana (RSBY)? = 2 or Does any member in your household have Other Central government health insurance schemes, please specify:______? = 2 or Does any member in your household have State government health insurance schemes, please specify:____ [Instruction for CAPI: Pre-load customized drop-down list of insurance schemes based on state]? = 2 or Does any member in your household have Community/ cooperative health insurance schemes, please specify:_____? = 2 or Does any member in your household have Medical reimbursement from an employer? = 2 or Does any member in your household have Health insurance through an employer , please specify:____? = 2 or Does any member in your household have privately purchased commercial health insurance, please specify:____? = 2 or Does any member in your household have Others, please specify ____? = 2 »
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HI010
[Ask only if HI002a-HI002j=2] What is the main reason for not having health insurance?
[ASK ONLY IF HI002A-HI002J=2] WHAT IS THE MAIN REASON FOR NOT HAVING HEALTH INSURANCE?
1 Don't know about health insurance
2 Cannot afford it
3 Do not need it
4 Do not know where to purchase it
5 Tried to get health insurance but was denied it.
6 Other, please specify ___________
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HI011
Who answered this section? [Instruction for the interviewer: Please identify the respondent from the household roster and enter Household Person ID.] Household Person ID: ______
WHO ANSWERED THIS SECTION? [INSTRUCTION FOR THE INTERVIEWER: PLEASE IDENTIFY THE RESPONDENT FROM THE HOUSEHOLD ROSTER AND ENTER HOUSEHOLD PERSON ID.] HOUSEHOLD PERSON ID: ______
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HI012
How often did the respondent receive assistance in answering this section?
HOW OFTEN DID THE RESPONDENT RECEIVE ASSISTANCE IN ANSWERING THIS SECTION?
1 Never
2 A few times
3 Most or all of the time
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End of HH_F. Health Insurance (HI)
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